Confirmed: Healthcare.gov run by incompetents

posted at 2:01 pm on October 22, 2013 by Ed Morrissey

Yes, this isn’t exactly breaking news, given all of the evidence we’ve seen since the rollout. Today, though, we have two conflicting reports pointing fingers at the government and at the contractors hired by the government, with both sides claiming that the other’s incompetence is what created the biggest debacle in the launch of a major government program in memory, and perhaps ever. First, CNN spoke to former Obama administration tech adviser Clay Johnson, who blamed the problem on “sloppy” contractors, but notes that the problems run deeper in government, too:

Clay Johnson, who served as a Presidential Innovation Fellow beginning in August 2012, wrote in a blog post on October 7 that signs of flaws on Healthcare.gov were apparent from the day it went online, including the use of placeholder text in the site’s code.

“The contractors who made this website were at best sloppy, and at worst unqualified for the job,” Johnson wrote. …

A separate posting on Johnson’s blog from Monday offered a few ways the site could be fixed, including the recommendation the administration hold the contractors responsible for the poorly-concocted website responsible.

“The problem here isn’t just the result of bad programming,” he wrote. “It’s the result of bad systems and bad architecture from the get-go. When you try and build the world’s biggest shopping mall and the only place you can buy your support beams from is a balsa-wood mill, your building is going to collapse.”

Opening the website to outside experts will help fix some of the problems, he wrote, but expecting substantial changes in a short amount of time could be unreasonable.

Au contraire, says the Associated Press, which interviewed the contractors. They tried raising red flags “for months” about the problems arising in the development of Healthcare.gov and the systems behind it, but the Obama administration ignored them. Furthermore, HHS decided to do its own testing rather than bring in experts, which explains why it happened late and had no impact on the rollout:

Crammed into conference rooms with pizza for dinner, some programmers building the Obama administration’s showcase health insurance website were growing increasingly stressed. Some worked past 10 p.m., energy drinks in hand. Others rewrote computer code over and over to meet what they considered last-minute requests for changes from the government or other contractors.

As questions mount over the website’s failure, insider interviews and a review of technical specifications by The Associated Press found a mind-numbingly complex system put together by harried programmers who pushed out a final product that congressional investigators said was tested by the government and not private developers with more expertise. …

A review of internal architectural diagrams obtained by the AP revealed the system’s complexity. Insurance applicants have a host of personal information verified, including income and immigration status. The system connects to other federal computer networks, including ones at the Social Security Administration, IRS, Veterans Administration, Office of Personnel Management and the Peace Corps.

Johnson makes a larger point about the lack of competence in government for private-sector activities:

“Healthcare.gov got this way not because of incompetence or sloppiness of an individual vendor, but because of a deeply engrained and malignant cancer that’s eating away at the federal government’s ability to provide effective online services,” he wrote.

“It’s a cancer that’s shut out the best and brightest minds from working on these problems, diminished competition for federal work, and landed us here – where you have half-billion dollar websites that don’t work,” he wrote, linking to USASpending.gov.

First, that problem seems to have first appeared on Obama’s watch. The Medicare Advantage website does exactly what the Healthcare.gov website is supposed to do — allow consumers to make choices of private insurance plans in part with subsidies from the federal government in the form of Medicare and Social Security benefits. That doesn’t involve a connection to the IRS, but neither do most of the problems seen at Healthcare.gov, either. Why HHS couldn’t use that as a model in its 42-month development of the exchange system is a mystery.

More importantly, though, this confirms that the issues aren’t the contractors, but the federal government agency that hired them. And if we take Johnson’s larger point to its natural conclusion, then we shouldn’t have the government involved in brokering private-sector transactions at all, nor in mandating that activity as tax law. Johnson’s right that the federal government has proven itself incompetent in running this kind of private-sector activity, which is why it should cease doing so and look for other ways to reform the health-insurance system.

Finally, when the finger-pointing starts, it’s a clear sign that (a) the project is a massive failure, and (b) no one really knows how to fix it.

Despite all the problems with Obamacare, there’s some good news on the horizon for medical care and costs. The good news has nothing to do with exchanges, reimbursement rates or “navigators,” but everything to do with a phenomenon that has cut costs elsewhere in American society: technology. …

This phenomenon holds true even for far more sophisticated technologies than just spring-loaded needles. Many schools — as well as malls, airports, and other public facilities — are installing Automated External Defibrillators. These are designed so that almost anyone can use them to administer life-saving resuscitation to someone whose heart has stopped or gone into deadly ventricular fibrillation. A computer in the device reads the victim’s EKG and administers a shock if called for. Voice commands tell the user what to do.

The proliferation of these defibrillators is a good thing, since sudden cardiac death is a serious problem, and it often strikes unlikely victims. But this is just the start.

That model has adults making their own decisions on purchases and preparing themselves to take charge of their own health care. The ObamaCare model forces government control in health care and treats adults like children. Given the competence demonstrated in the latter model, I’d hope that the former model emerges … and soon.

Update: I fixed a sentence that was left incomplete in the original post.

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